Exam 3-Care of Aging Adults

A gerontological nurse is conducting a health promotion program for a group of older adults about activities specific to the integumentary system. The nurse determines that the teaching was successful based on which statement?

"I'm aware that irregularly shaped moles can be associated with melanoma."

A nurse who works in an oncologist's office is talking with a client diagnosed with cancer who has exhausted all conventional treatments. The client says she has heard that she can be cured by a healer who uses massage therapy. Which response by the nurse would be most therapeutic?

"Let's check the National Cancer Institute website to find out about this treatment."

A nurse is counseling an older adult male client about ways to reduce the risk for cancer. Which instruction would the nurse include as a way to reduce the client's risk for prostate cancer?

"Maintaining your weight within an ideal range will reduce the risk."

A nurse is making a home visit to an older adult client diagnosed with Alzheimer's disease. During the visit, the client's spouse asks, "What would be most helpful in slowing the symptoms?" Which response by the nurse would be most appropriate?

"There are medications that can slow down the progression by affecting an enzyme that acts on acetylcholine."

The son and daughter of an 80-year-old client have expressed concern to the nurse that their mother has become extremely impatient and irritable since her stroke earlier in the year. Which response by the nurse would be most appropriate?

"This is not uncommon after a stroke. It must be difficult for you to see, since it is uncharacteristic of her personality."

A 76-year-old client's quality of life has been significantly affected by chronic obstructive pulmonary disease (COPD). The client has experienced a steady decline in activity tolerance, mobility, and ultimately independence. Considering the apparent ineffectiveness of conventional treatment, the client is eager to forego conventional treatments and explore alternative and complementary treatment options. Which response by the nurse would be most appropriate?

"Try not to think of your options as choosing either conventional treatment or alternative therapies, but rather choosing the best of both."

A 71-year-old man has been diagnosed with gout. When teaching the client about dietary recommendations, which suggestion would the nurse most likely include?

"You should avoid alcohol as well as many kinds of meat and seafood."

A 76-year-old resident of an assisted living facility has just been diagnosed with chronic glaucoma. Which information would the nurse expect to share with the client about treatment?

"You will most likely be prescribed eye drops that you will need to instill regularly."

A nurse is assessing an older client for depression using the Geriatric Depression Scale-Short Form. Which score would the nurse interpret as indicative of depression?

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The nurse assesses several older adult clients to determine factors placing the clients at risk for integumentary problems. Which client would the nurse identify as facing the most acute threat to health?

A 66-year-old retired farmer who has been diagnosed with melanoma following a lifetime of sun exposure.

Several older adult clients are being cared for on a subacute medical unit. After assessing each client, which client would the nurse identify as being at highest risk for a cerebrovascular accident (CVA)?

A 79-year-old who has poorly controlled hypertension and smokes half a pack of cigarettes daily

The nurse plans care for a client who has had gradual vision loss. Which of the following should the nurse include in the care plan?

A clock that chimes the hour in the client's living room

A gerontological nurse is conducting a program for a group of nurses working at the long-term care facility about aging and musculoskeletal functioning. Which statement would the nurse most likely include when describing this relationship?

A combination of age-related reduction in muscle mass and inactivity decreases musculoskeletal function.

A daughter brings her older adult parent to the community health center for an evaluation. Which assessment findings would lead the nurse to suspect that the client is experiencing depression? Select all that apply

A. Inattention to hygiene C. Complaints of anorexia D. Changes in sleep patterns

A gerontological nurse is conducting a presentation about cancer and older adults for a group of older adults at a local senior center. The nurse is describing the relationship between cancer and aging. Which information would the nurse most likely include?

Age is considered the most significant risk factor for cancer.

An 84-year-old client has dry skin and accompanying pruritus. The client asks the nurse for a suggestion about what complementary therapy to use to assist with this problem. The nurse would most likely suggest which therapy?

Aloe vera

An older adult resident in a nursing home is considered noncompliant by many of the staff because the client refuses to eat some of the food, which is nourishing and has been carefully planned by a dietitian. Most other residents have no objection to the meals. In addition, the client sometimes skips exercise classes. On the other hand, the client takes all the prescribed medicines, and gets along well with the other residents, to whom the client is often heard telling risqué jokes. When reviewing the client's status, which area would the nurse identify as being successfully met by the client?

Assertiveness

As per her routine, the daughter of an 82-year-old client recovering from a prostate resection has come to the hospital in the morning to be at the bedside. The daughter has approached her father's nurse and stated that he is uncharacteristically difficult to rouse this morning, with his only verbal response being occasional nonsensical muttering. Which activity would be most appropriate?

Assessment to determine the cause of the client's delirium.

To the embarrassment of his family, an 81-year-old male client on the subacute unit of a hospital has made repeated, sexually inappropriate statements to female staff members. The client's family is adamant that such behavior is uncharacteristic. Which action would the nurse implement first?

Attempt to identify the underlying cause of the client's behavior.

A nurse has admitted a 79-year-old female client to the unit from the emergency department following a fall. A diagnosis of osteoporosis is confirmed in the client's medical history. Assessment also reveals that the client displays kyphosis. Which medication would the nurse anticipate administering to the client? Select all that apply.

Calcitonin Calcium supplements Vitamin D supplements Estrogen

An older adult client has been confined to bed for the past 3 months. Which occurrence should the nurse anticipate secondary to this prolonged immobility?

Bone demineralization

An older adult with cancer asks the nurse about using complementary and alternative medicine (CAM) treatments for cancer. Which response by the nurse would be most appropriate?

CAM practitioners honor clients' rights to control their care and their lives, seeing their role as empowering, facilitating, and supporting patients in the healing process.

The nurse is assessing an older adult client's hearing. Which finding would lead the nurse to suspect that the client is experiencing a problem? Select all that apply.

Client consistently asking, "What did you say?" Client asks to have words repeated Client looks directly at speaker's lips during interview Client has head turned to one side

A nurse is providing care for an 82-year-old client on the palliative care unit of a hospital. The client has a long-standing diagnosis of diabetes that has manifested in serious cardiac problems. The client is not expected to survive the weekend. Which interpretation would be most appropriate by the nurse in light of the chronic care that the client has long received?

Dying in comfort and dignity is the final component of high-quality chronic care.

A gerontological nurse is initiating programs for clients at a local senior center to assist with the prevention and early diagnosis of cancer in this population. Which intervention would the nurse most likely include in these programs? Select all that apply.

Encouraging healthy lifestyle habits in persons of all ages can help reduce the risk factors for developing cancer. Educating clients about cancer screening and facilitating their efforts to obtain tests can enable cancers to be detected in early stages, thereby increasing survival rates.

A nurse is assessing an older adult client brought to the emergency department by a sibling. The nurse suspects alcohol abuse based on which assessment findings? Select all that apply.

Frequent injuries or falls due to clumsiness Keeping to oneself Episodes of blackouts Use of alcohol to calm nerves

A home care nurse is making a visit to an older adult client. During the visit, the nurse notes that the client has cerumen accumulated in the left ear. The nurse assists the client in removing it. Which action would be appropriate?

Gently irrigating the external auditory canal with warm water.

A nurse is developing a plan of care for an older adult client with several chronic conditions. Which information would be most important for the nurse to integrate into the plan when identifying goals for the client? Select all that apply.

Healing requires the mobilization of the body, mind, and spirit Appropriate care measures focus on helping clients live in harmony with chronic disease. Controlling symptoms, promoting a sense of well-being, and enhancing the quality of life are appropriate goals for persons with chronic illnesses.

A gerontological nurse at a wellness center is conducting an exercise program for older adult clients with diabetes. The nurse cautions the clients to exercise with caution for which reason?

Hypoglycemia may occur

An older adult has experienced a progressive loss of mobility over the last several years because of multiple sclerosis. Combined with a narrowing social circle, the client has characterized life as "not worth living" and expressed to her nurse a desire to "end it all." Which response by the nurse would be most appropriate?

Implement measures to ensure the client's safety.

A nurse is preparing a presentation about chronic conditions and older adults. The nurse identifies the need to address the high incidence and prevalence of these conditions among this population. Which phenomenon would the nurse most likely include as contributing to the high incidence? Select all that apply.

Longevity is increasing. Many previously fatal diseases are now treatable.

A nurse is conducting a presentation to a group of older adults at the local senior center about visual changes. After teaching the group about these changes, the nurse determines that the teaching was successful when the group identifies which condition as the most common cause of blindness in people over age 65 years?

Macular degeneration

A nurse is preparing a program at a local health fair, promoting activities to reduce clients' risk of cerebrovascular accident (CVA). Which activity would the nurse emphasize as the most helpful measure for risk reduction? Select all that apply.

Maintaining adequate hydration Controlling diabetes Managing hypertension

The nurse receives medication orders for an 84-year-old client with glaucoma. Which medication would the nurse expect to administer?

Miotics

The nurse is providing care to a group of older adult clients. The nurse would anticipate administering an anti-inflammatory medication to which client?

Patients with rheumatoid arthritis may be prescribed anti-inflammatory agents

The nurse encourages an 80-year-old client not to fall asleep slumped in the recliner to prevent the possibility of transient ischemic attacks (TIAs). When explaining the rationale for this action, which effect would the nurse describe?

Prevention of impaired cerebral blood flow

A 70-year-old resident of a long-term care facility is in the advanced stages of Alzheimer's disease. Consequently, the resident frequently wanders throughout and, on more than one occasion, outside the facility. Due to cognitive deficits, the client is not responsive to teaching and redirection. Which action by the staff would be most appropriate response to the resident's behavior?

Provide a controlled and safe place within which the resident can wander freely around.

A home health care nurse is providing care to an older adult client with chronic conditions. Which intervention would be most appropriate for the nurse to implement to best ensure proper care for a client when the nurse is not present but can be reached by a telephone or pager?

Provide detailed written instructions for all procedures.

A nurse is providing care for a client who is in the late stages of vascular dementia. The nurse is in the habit of reorienting the client to person, place, and time. Which statement best explains the nurse's action?

Reality orientation can be a useful, beneficial intervention when it is used appropriately

A 78-year-old resident with a diagnosis of melanoma is experiencing anxiety related to the appearance of the large and highly visible lesion on the right cheek. Which intervention would be most appropriate for the nurse to implement to help decrease the resident's anxiety?

Resolve to interact with and touch the resident no differently than other residents.

A gerontological nurse is conducting a program for staff nurses at a long-term care facility about older adults and sensory function. When discussing this topic, which information would the nurse most likely include? Select all that apply.

Sensory deficits have a deleterious effect on safety, relationships, communication, and perception. Lifestyle modifications cannot prevent all sensory deficits.

A 70-year-old client has just been diagnosed with Parkinson's disease. The nurse is working with the client and family, teaching them about communicating with the client. Which information would the nurse incorporate into the discussion?

The disease progresses slowly with therapy helping to minimize disability.

A client experienced a cerebrovascular accident and now has expressive aphasia. When providing care to this client, which intervention would be the priority?

Using a picture chart

The son of a nursing home resident asks the nurse, "Why are you making my mother get out of bed and do simple morning exercises when she would rather sleep?" When responding to the client's son, which reason would be the best for the nurse to incorporate into the response?

The exercise is necessary for promoting circulation.

A 71-year-old male client been diagnosed with colon cancer after a recent colonoscopy. On a recent follow-up visit, the client appears anxious about the diagnosis. Which response by the nurse would be most appropriate?

This must be very stressful for you. What people can you rely on for support?"

A gerontological nurse initiates a program at the long-term care facility to motivate residents to move and be active. Which rationale would the nurse incorporate into the plan as useful in stimulating opportunities for activity?

Those engaged in social events are more likely to perform self-care.

The nurse observes an 83-year-old resident of a nursing home scratching repeatedly over the last several days. The resident states, "I'm so itchy these days it drives me crazy." Which measure would the nurse most likely implement as the priority?

Topical application of zinc oxide

A gerontological nurse is conducting a program for a group of older adults at a senior center about dementia. One of the group members asks, "I know about Alzheimer's disease, but are there other common causes of dementia in older adults?" Which information would the nurse most likely include as a common cause? Select all that apply.

Trauma and small cerebral blood vessel infarcts leading to vascular dementia are common causes of dementia.

A 79-year-old client with type 2 diabetes in very good health has a lipid screening during a visit to the nurse practitioner. Which triglyceride level would the nurse identify as desirable for this client?

Triglycerides 149 mg/dL

The nurse is providing care to an older adult resident of a nursing home who has diabetes. Which finding would the nurse be alert for as an early indicator of hypoglycemia?

behavior disorders, convulsions, somnolence, confusion, disorientation, poor sleep patterns, nocturnal headache, slurred speech, and unconsciousness.

The nurse practitioner is interviewing an 80-year-old client who has come to the health center for a visit. The client tells the nurse, "I've been dealing with constipation for so long, but now, it seems to have stopped and I'm having normal bowel movements again. I've been hungrier lately and I've been having trouble sleeping." Based on the client's statement, which condition would the nurse most likely suspect?

hyperthyroidism

A 76-year-old client has been prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which assessment would the nurse most likely identify as the priority during the initial days of the client's drug therapy?

monitor for changes in the client's nutritional status

A nurse is developing a teaching program for a 66-year-old adult who was just diagnosed with type 2 diabetes. When providing this teaching, which educational material would be most appropriate for the nurse to use?

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